Provider Demographics
NPI:1043774052
Name:HOCTOR, COLLIN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:COLLIN
Middle Name:
Last Name:HOCTOR
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 150671
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94915-0671
Mailing Address - Country:US
Mailing Address - Phone:415-755-3367
Mailing Address - Fax:
Practice Address - Street 1:712 D ST STE P
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3706
Practice Address - Country:US
Practice Address - Phone:415-755-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104234106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist